Hygroton Side Effects

Note: This page contains information about the side effects of chlorthalidone. Some of the dosage forms included on this document may not apply to the brand name Hygroton.

Not all side effects for Hygroton may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to chlorthalidone: oral tablet

In addition to its needed effects, some unwanted effects may be caused by chlorthalidone (the active ingredient contained in Hygroton). In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking chlorthalidone:

dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly

dry mouth

fast heartbeat

fatigue

fever

flushed, dry skin

fruit-like breath odor

general feeling of tiredness or weakness

headache

increased hunger

increased thirst

increased urination

indigestion

itching

joint pain, stiffness, or swelling

loss of appetite

lower back or side pain

nausea

pain in joints or muscles

painful or difficult urination

pains in stomach, side, or abdomen, possibly radiating to the back

pinpoint red spots on skin

red irritated eyes

red skin lesions, often with a purple center

redness, soreness or itching skin

shortness of breath

skin rash

sore throat

sores, ulcers, or white spots on lips or in mouth

sores, welting, or blisters

sugar in the urine

sweating

swelling of feet or lower legs

swollen glands

tightness in chest

troubled breathing

unpleasant breath odor

unusual bleeding or bruising

unusual tiredness or weakness

unusual weight loss

vomiting

vomiting of blood

weight loss

wheezing

yellow eyes or skin

Some of the side effects that can occur with chlorthalidone may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Incidence not known

Cramping

decreased interest in sexual intercourse

difficulty having a bowel movement (stool)

feeling of constant movement of self or surroundings

hives

inability to have or keep an erection

increased sensitivity of skin to sunlight

loss in sexual ability, desire, drive, or performance

muscle spasm

redness or other discoloration of skin

restlessness

sensation of spinning

severe sunburn

weakness

For Healthcare Professionals

Applies to chlorthalidone: oral tablet

Metabolic

In a prospective study of 83 patients who were taking daily doses of chlorthalidone (the active ingredient contained in Hygroton) 200 mg, 23 (28%) developed a decrease in their serum potassium (K+) concentration by at least 0.6 mEq/L. Keeping the serum K+ replenished during therapy decreases the risk of arrhythmias, myopathy, hyponatremia and abnormal glucose metabolism. Concomitant administration of an angiotensin converting enzyme (ACE) inhibitor can decrease the risk of hypokalemia. (ACE inhibitors decrease serum aldosterone.)[Ref]

There may be significant metabolic side effects of chlorthalidone, as with other thiazide diuretics. Approximately 14% of patients develop hypokalemia during therapy. The risk of hypokalemia, hypomagnesemia, hyponatremia, and hypochloremia appears to be dose-related. Hypercalcemia and an increased serum bicarbonate may result from chlorthalidone diuresis.[Ref]

Cardiovascular

The initial report from the Multiple Risk Factor Intervention Trial (MRFIT) raised the possibility that the increased coronary heart disease (CHD) mortality observed in a subset of men with hypertension who were taking diuretics may be misleading. Subsequent analysis of the data reveals no consistent relationship between CHD mortality and the dose of chlorthalidone (the active ingredient contained in Hygroton) the most recent serum potassium concentration, or the presence of premature ventricular depolarizations (PVDs). It is probable that these men had left ventricular hypertrophy, which is associated with a greater incidence of PVDs, even in the absence of diuretic therapy.

Chlorthalidone-induced hypokalemia can rarely cause serious arrhythmias in otherwise healthy patients. It is recommended that the serum potassium concentration be kept within normal limits during chlorthalidone therapy, especially in patients who are predisposed to arrhythmias.[Ref]

Cardiovascular side effects are related to decreased intravascular volume and hypokalemia. Hypokalemia may induce or provoke arrhythmias in some patients. Orthostatic hypotension and syncope have been reported in rare cases.[Ref]

Hypersensitivity

Hypersensitivity reactions to thiazide diuretics usually involve the skin. Thiazides and chlorthalidone (the active ingredient contained in Hygroton) have been implicated as the cause of necrotizing vasculitis, psoriasiform eruptions, and pseudoporphyria (bullous photosensitive lesions) in rare cases.[Ref]

Renal

New or worsened renal insufficiency may develop if patients become too dehydrated. The use of chlorthalidone (the active ingredient contained in Hygroton) has been associated with mild decreases in urine concentrating ability and renal plasma flow, suggestive of interference with renal tubular function.[Ref]

Nervous system

Nervous system side effects include sleep disturbances in 18% of patients, which may be made worse with a sodium-restricted diet. Headache or fatigue have been reported in approximately 7% of patients.[Ref]

Endocrine

Endocrinologic abnormalities related to chlorthalidone (the active ingredient contained in Hygroton) as with other thiazide diuretics, include decreased glucose tolerance and an adverse effect on the lipid profile. This may be important in some patients with a history of diabetes or coronary artery disease.[Ref]

Use of chlorthalidone has been associated with increases in total serum cholesterol, triglycerides, and LDL cholesterol.

At least one case of severe glucose intolerance, resulting in hyperosmolar hyperglycemic nonketotic coma, has been associated with chlorthalidone. The patient did not have diabetes, had a normal fasting blood glucose prior to chlorthalidone therapy, and did well on no antidiabetic medications after resolution of the acute episode of hyperglycemia. Infection and myocardial infarction were ruled out.[Ref]

Genitourinary

The etiology of sexual dysfunction associated with chlorthalidone (the active ingredient contained in Hygroton) is not known. One study of 19 middle-aged hypertensive men showed no significant decrease in serum zinc or testosterone relative to a control group of 31 unmedicated middle-aged normotensive men. While sexual dysfunction was reported in 42% of treated men (compared to 16% in the control group), serum testosterone and zinc levels were actually higher in the treated group, and were highest in the men on the highest dose of chlorthalidone.

One study revealed that sexual dysfunction associated with chlorthalidone may be worsened by a low sodium diet and ameliorated by a diet designed to help lose weight. The influence of diet alone or the associated nutritional counseling and sense of well-being on sexual function was not measured.

The Treatment of Mild Hypertension Study (TOMHS), a randomized, placebo-controlled, double-blind study has shown that there is a significantly higher incidence of sexual dysfunction (obtaining and maintaining erections) among male patients who were taking chlorthalidone at 24 and 48 months compared with placebo.[Ref]

Genitourinary complaints of decreased sexual libido and erections have been reported in up to 42% of male patients. Decreased sexual arousal and orgasm have rarely been reported among female patients.[Ref]

Musculoskeletal

Musculoskeletal weakness or cramps have been reported in approximately 7% of patients. Chlorthalidone-induced hypokalemia has resulted in hypokalemic myopathy in rare cases.[Ref]

Cases of progressive generalized paralysis associated with chlorthalidone-induced hypokalemia have been reported. In some of these cases, muscle histology is remarkable for vacuolar degeneration.[Ref]

Gastrointestinal

Gastrointestinal complaints are unusual. Approximately 5% to 10% of patients complain of nausea, vomiting, abdominal cramping, diarrhea, or constipation. A case of acute bacterial pancreatitis and rare cases of intrahepatic cholestasis have been associated with chlorthalidone (the active ingredient contained in Hygroton) [Ref]

Hematologic

A 63-year-old man with hypertension, ischemic heart disease, chronic bronchitis, and type II diabetes mellitus was stable on multiple medications until chlorthalidone (the active ingredient contained in Hygroton) was substituted for hydrochlorothiazide. Within three weeks after beginning chlorthalidone, the patient developed a diffuse, upper extremity pruritic rash, fever, dyspnea, malaise, and fatigue associated with a peripheral leukocyte count of 2,000/mm3. Bone marrow aspiration revealed hypocellularity of the myeloid line only. Within nine days after stopping chlorthalidone, the patient's leukocyte count returned to normal. No other cause of neutropenia was discovered; the presence of an antineutrophil antibody was not proven.[Ref]

Hematologic side effects that have been rarely associated with chlorthalidone include neutropenia, agranulocytosis, thrombocytopenia, and aplastic anemia.[Ref]

Ocular

The mechanism of myopia is unknown. There is evidence of an allergic reaction, where the ciliary body may become edematous, and of a direct disturbance of the normal salinity of the lens. Either may alter the refractive index. In some cases, ultrasonography of affected eyes has shown a difference both in the anterior chamber depth and in the lens thickness during chlorthalidone (the active ingredient contained in Hygroton) therapy.[Ref]

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